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General NPI Number Information
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NPI Number | 1972002269
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Entity Type | Organization
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Legal Business Name | TREE OF LIFE SPECIAL NEEDS ADULT CENTER LLC
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 4045 C 13TH STREET
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City | SAINT CLOUD
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State | FL
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Zip | 34769
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Country | US
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Telephone | 407-421-1812
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Fax |
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Provider Business Mailing Address
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Address Line | 3912 PORT SEA PL
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City | KISSIMMEE
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State | FL
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Zip | 34746-1808
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Country | US
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Telephone | 407-421-1812
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA V GARCIA
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Credential | P.T.
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Telephone | 407-791-0892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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